SOS (Save Our Students) Bully Tip Form
This form is used to submit tips on harassment, intimidation and bullying. Bullying is when a person or group of people repeatedly cause hurt or harm to a person or group of people who feel helpless to respond.
Role of person completing form
Clear selection
Targeted Student's Name (victim)
Incident Date
MM
/
DD
/
YYYY
How did you learn about the bullying
Did a physical injury result from the incident
Clear selection
Describe any physical injuries if they occurred.
Why do you think the harassment, intimidation or bullying occurred?
Name of school adult you've already contacted (if any)
Name of Bully or Bullies
What Happened?
Where did the incident happen?
Witness(es)
Name of reporting person (unless wish to remain anonymous)
Submit
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